| Literature DB >> 31434721 |
Sohei Harada1,2,3, Kotaro Aoki2, Shungo Yamamoto4, Yoshikazu Ishii2, Noritaka Sekiya5, Hanako Kurai6, Keiichi Furukawa7, Asako Doi8, Kentaro Tochitani4, Kenji Kubo9, Yukihiro Yamaguchi10, Masashi Narita11,12, Shinya Kamiyama13, Jun Suzuki14, Takahiko Fukuchi15, Yoshiaki Gu16, Keiji Okinaka17, Soichi Shiiki12, Kayoko Hayakawa18, Natsuo Tachikawa19, Kei Kasahara20, Tadahiro Nakamura21, Kyoko Yokota22,23, Masanari Komatsu24, Misaki Takamiya25, Kazuhiro Tateda2, Yohei Doi26.
Abstract
Although hypervirulent Klebsiella pneumoniae (hvKp) has been associated with severe community-acquired infections that occur among relatively healthy individuals, information about hvKp infections in health care settings remains limited. Here, we systematically analyzed the clinical and molecular characteristics of K. pneumoniae isolates causing bloodstream infections in a cross-sectional study. Clinical characteristics of K. pneumoniae bloodstream infections from hospitals across Japan were analyzed by a review of the medical records. Whole-genome sequencing of the causative isolates was performed. Bacterial species were confirmed and hvKp were identified using whole-genome sequencing data. Clinical characteristics of hvKp infections were compared with those of non-hvKp infections by bivariate analyses. Of 140 cases of K. pneumoniae bloodstream infections, 26 cases (18.6%) were caused by various clones of hvKp defined by the carriage of cardinal virulence genes. Molecular identification revealed that 24 (17.1%) and 14 (10%) cases were caused by Klebsiella variicola and Klebsiella quasipneumoniae, respectively. Patients with hvKp infections had higher proportions of diabetes mellitus (risk ratio [RR], 1.75; 95% confidence interval [CI], 1.05 to 2.94), and their infections had significantly higher propensity to involve pneumonia (RR, 5.85; 95% CI, 1.39 to 24.6), liver abscess (RR, 5.85; 95% CI, 1.39 to 24.6), and disseminated infections (RR, 6.58; 95% CI, 1.16 to 37.4) than infections by other isolates. More than one-half of hvKp infections were health care associated or hospital acquired, and a probable event of health care-associated transmission of hvKp was documented. hvKp isolates, which are significantly associated with severe and disseminated infections, are frequently involved in health care-associated and hospital-acquired infections in Japan.Entities:
Keywords: bloodstream infection; disseminated infection; hypervirulent Klebsiella pneumoniae; whole-genome sequencing
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Year: 2019 PMID： 31434721 PMCID： PMC6812994 DOI： 10.1128/JCM.01206-19
Source DB: PubMed Journal: J Clin Microbiol ISSN： 0095-1137 Impact factor: 5.948